• Kimbra Kenney, Mark E Landau, Rodney S Gonzalez, Julie Hundertmark, Karen O'Brien, and William W Campbell.
• Department of Neurology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814, USA. kkenney@usuhs.mil
• Muscle Nerve. 2012 Mar 1; 45 (3): 356-62.

IntroductionIn this investigation we assessed the spectrum of creatine kinase (CK) responses in military recruits undergoing basic training.MethodsMusculoskeletal examination data, questionnaire findings, and CK levels were obtained from 499 recruits at days 0, 3, 7, and 14 of training. Correlations of CK with ethnicity, age, body mass index, exercise, muscle pain, and climate were obtained.ResultsNone of the subjects developed clinical exertional rhabdomyolysis (ER). The mean/median serum CK values were 223/157, 734/478, 1226/567, and 667/486 IU/L at days 0, 3, 7, and 14, respectively, with a wide overall range (34-35,056 IU/L). African-American subjects had higher mean CK levels.ConclusionsCK elevations and muscle pain are common during basic training. Widely accepted laboratory diagnostic values for ER are routinely exceeded in this military recruits, suggesting that CK levels >50 times the upper limit of normal are more specific. The findings support using CK as a marker for ER. Normal laboratory reference ranges for CK should be published by ethnicity.Copyright © 2011 Wiley Periodicals, Inc.

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